Surgical instrument including a deployable knife

ABSTRACT

An apparatus comprises a body, a shaft assembly, an end effector, a cartridge, and a staple driver actuator. The end effector is operable to manipulate tissue. The end effector comprises a lower jaw, a pivotable anvil, and a translating cutter. The translating cutter is operable to translate relative to the lower jaw and the anvil when the anvil is pivoted toward the lower jaw to manipulate tissue. The cartridge is insertable into the lower jaw and includes a plurality of staples. The staple driver actuator is disposed within the cartridge. The staple driver actuator comprises a secondary cutting element. The translating cutter of the end effector is operable to drive the staple driver actuator distally to staple and cut tissue substantially simultaneously.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation application claiming priority under35 U.S.C. § 120 to U.S. patent application Ser. No. 16/131,148, entitledSURGICAL STAPLER WITH PLURALITY OF CUTTING ELEMENTS, filed Sep. 14,2018, which issued on Sep. 21, 2021 as U.S. Pat. No. 11,123,069, whichis a continuation application claiming priority under 35 U.S.C. § 120 toU.S. patent application Ser. No. 14/489,746, entitled SURGICAL STAPLERWITH PLURALITY OF CUTTING ELEMENTS, filed Sep. 18, 2014, which issued onOct. 23, 2018 as U.S. Pat. No. 10,105,142, the entire disclosures ofwhich are hereby incorporated by reference herein.

BACKGROUND

In some settings, endoscopic surgical instruments may be preferred overtraditional open surgical devices since a smaller incision may reducethe post-operative recovery time and complications. Consequently, someendoscopic surgical instruments may be suitable for placement of adistal end effector at a desired surgical site through the cannula of atrocar. These distal end effectors may engage tissue in a number of waysto achieve a diagnostic or therapeutic effect (e.g., endocutter,grasper, cutter, stapler, clip applier, access device, drug/gene therapydelivery device, and energy delivery device using ultrasonic vibration,RF, laser, etc.). Endoscopic surgical instruments may include a shaftbetween the end effector and a handle portion, which is manipulated bythe clinician. Such a shaft may enable insertion to a desired depth androtation about the longitudinal axis of the shaft, thereby facilitatingpositioning of the end effector within the patient. Positioning of anend effector may be further facilitated through inclusion of one or morearticulation joints or features, enabling the end effector to beselectively articulated or otherwise deflected relative to thelongitudinal axis of the shaft.

Examples of endoscopic surgical instruments include surgical staplers.Some such staplers are operable to clamp down on layers of tissue, cutthrough the clamped layers of tissue, and drive staples through thelayers of tissue to substantially seal the severed layers of tissuetogether near the severed ends of the tissue layers. Merely exemplarysurgical staplers are disclosed in U.S. Pat. No. 4,805,823, entitledPOCKET CONFIGURATION FOR INTERNAL ORGAN STAPLERS, issued Feb. 21, 1989;U.S. Pat. No. 5,415,334, entitled SURGICAL STAPLER AND STAPLE CARTRIDGE,issued May 16, 1995; U.S. Pat. No. 5,465,895, entitled SURGICAL STAPLERINSTRUMENT, issued Nov. 14, 1995; U.S. Pat. No. 5,597,107, entitledSURGICAL STAPLER INSTRUMENT, issued Jan. 28, 1997; U.S. Pat. No.5,632,432, entitled SURGICAL INSTRUMENT, issued May 27, 1997; U.S. Pat.No. 5,673,840, entitled SURGICAL INSTRUMENT, issued Oct. 7, 1997; U.S.Pat. No. 5,704,534, entitled ARTICULATION ASSEMBLY FOR SURGICALINSTRUMENTS, issued Jan. 6, 1998; U.S. Pat. No. 5,814,055, entitledSURGICAL CLAMPING MECHANISM, issued Sep. 29, 1998; U.S. Pat. No.6,978,921, entitled SURGICAL STAPLING INSTRUMENT INCORPORATING AN E-BEAMFIRING MECHANISM, issued Dec. 27, 2005; U.S. Pat. No. 7,000,818,entitled SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSINGAND FIRING SYSTEMS, issued Feb. 21, 2006; U.S. Pat. No. 7,143,923,entitled SURGICAL STAPLING INSTRUMENT HAVING A FIRING LOCKOUT FOR ANUNCLOSED ANVIL, issued Dec. 5, 2006; U.S. Pat. No. 7,303,108, entitledSURGICAL STAPLING INSTRUMENT INCORPORATING A MULTI-STROKE FIRINGMECHANISM WITH A FLEXIBLE RACK, issued Dec. 4, 2007; U.S. Pat. No.7,367,485, entitled SURGICAL STAPLING INSTRUMENT INCORPORATING AMULTISTROKE FIRING MECHANISM HAVING A ROTARY TRANSMISSION, issued May 6,2008; U.S. Pat. No. 7,380,695, entitled SURGICAL STAPLING INSTRUMENTHAVING A SINGLE LOCKOUT MECHANISM FOR PREVENTION OF FIRING, issued Jun.3, 2008; U.S. Pat. No. 7,380,696, entitled ARTICULATING SURGICALSTAPLING INSTRUMENT INCORPORATING A TWO-PIECE E-BEAM FIRING MECHANISM,issued Jun. 3, 2008; U.S. Pat. No. 7,404,508, entitled SURGICAL STAPLINGAND CUTTING DEVICE, issued Jul. 29, 2008; U.S. Pat. No. 7,434,715,entitled SURGICAL STAPLING INSTRUMENT HAVING MULTISTROKE FIRING WITHOPENING LOCKOUT, issued Oct. 14, 2008; U.S. Pat. No. 7,721,930, entitledDISPOSABLE CARTRIDGE WITH ADHESIVE FOR USE WITH A STAPLING DEVICE,issued May 25, 2010; U.S. Pat. No. 8,408,439, entitled SURGICAL STAPLINGINSTRUMENT WITH AN ARTICULATABLE END EFFECTOR, issued Apr. 2, 2013; andU.S. Pat. No. 8,453,914, entitled MOTOR-DRIVEN SURGICAL CUTTINGINSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY, issuedJun. 4, 2013. The disclosure of each of the above-cited U.S. patents isincorporated by reference herein.

While the surgical staplers referred to above are described as beingused in endoscopic procedures, it should be understood that suchsurgical staplers may also be used in open procedures and/or othernon-endoscopic procedures. By way of example only, a surgical staplermay be inserted through a thoracotomy, and thereby between a patient'sribs, to reach one or more organs in a thoracic surgical procedure thatdoes not use a trocar as a conduit for the stapler. Such procedures mayinclude the use of the stapler to sever and close a vessel leading to alung. For instance, the vessels leading to an organ may be severed andclosed by a stapler before removal of the organ from the thoraciccavity. Of course, surgical staplers may be used in various othersettings and procedures.

Examples of surgical staplers that may be particularly suited or usethrough a thoracotomy are disclosed in U.S. Patent ApplicationPublication No. 2014/0243801, entitled SURGICAL INSTRUMENT END EFFECTORARTICULATION DRIVE WITH PINION AND OPPOSING RACKS, published Aug. 28,2014, now U.S. Pat. No. 9,186,142; U.S. Patent Application PublicationNo. 2014/0239041, entitled LOCKOUT FEATURE FOR MOVABLE CUTTING MEMBER OFSURGICAL INSTRUMENT, published Aug. 28, 2014, now U.S. Pat. No.9,717,497; U.S. Patent Application Publication No. 2014/0239042,entitled INTEGRATED TISSUE POSITIONING AND JAW ALIGNMENT FEATURES FORSURGICAL STAPLER, published Aug. 28, 2014, now U.S. Pat. No. 9,517,065;U.S. Patent Application Publication No. 2014/0239036, entitled JAWCLOSURE FEATURE FOR END EFFECTOR OF SURGICAL INSTRUMENT, published Aug.28, 2014, now U.S. Pat. No. 9,839,421; U.S. Patent ApplicationPublication No. 2014/0239040, entitled SURGICAL INSTRUMENT WITHARTICULATION LOCK HAVING A DETENTING BINARY SPRING, published Aug. 28,2014, now U.S. Pat. No. 9,867,615; U.S. Patent Application PublicationNo. 2014/0239043, entitled DISTAL TIP FEATURES FOR END EFFECTOR OFSURGICAL INSTRUMENT, published Aug. 28, 2014, now U.S. Pat. No.9,622,746; U.S. Patent Application Publication No. 2014/0239037,entitled STAPLE FORMING FEATURES FOR SURGICAL STAPLING INSTRUMENT,published Aug. 28, 2014, now U.S. Pat. No. 10,092,292; U.S. PatentApplication Publication No. 2014/0239038, entitled SURGICAL INSTRUMENTWITH MULTI-DIAMETER SHAFT, published Aug. 28, 2014, now U.S. Pat. No.9,795,379; and U.S. Patent Application Publication No. 2014/0239044,entitled INSTALLATION FEATURES FOR SURGICAL INSTRUMENT END EFFECTORCARTRIDGE, published Aug. 28, 2014, now U.S. Pat. No. 9,808,248. Thedisclosure of each of the above-cited U.S. patent applications isincorporated by reference herein.

While various kinds of surgical stapling instruments and associatedcomponents have been made and used, it is believed that no one prior tothe inventor(s) has made or used the invention described in the appendedclaims.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the invention,and, together with the general description of the invention given above,and the detailed description of the embodiments given below, serve toexplain the principles of the present invention.

FIG. 1 depicts a perspective view of an exemplary articulating surgicalstapling instrument;

FIG. 2 depicts a side elevational view of the instrument of FIG. 1;

FIG. 3 depicts a perspective view of an end effector of the instrumentof FIG. 1, with the end effector in a closed configuration;

FIG. 4 depicts a perspective view of the end effector of FIG. 3, withthe end effector in an open configuration;

FIG. 5 depicts an exploded perspective view of the end effector of FIG.3;

FIG. 6 depicts a cross-sectional end view of the end effector of FIG. 3,taken along line 6-6 of FIG. 4;

FIG. 7A depicts a cross-sectional side view of the end effector of FIG.3, taken along line 7-7 of FIG. 4, with a firing beam in a proximalposition;

FIG. 7B depicts a cross-sectional side view of the end effector of FIG.3, taken along line 7-7 of FIG. 4, with the firing beam in a distalposition;

FIG. 8 depicts a perspective view of the end effector of FIG. 3,positioned at tissue and having been actuated once in the tissue;

FIG. 9 depicts a schematic view of an exemplary control circuit for usein the instrument of FIG. 1;

FIG. 10 depicts a perspective view of the handle assembly of theinstrument of FIG. 1, with a housing half and some internal componentsremoved;

FIG. 11 depicts a perspective view of drive assembly components from thehandle assembly of FIG. 10;

FIG. 12 depicts a perspective view of an elongate member from the driveassembly of FIG. 11, coupled with the firing beam;

FIG. 13 depicts a partial perspective view of an exemplary staplecartridge of the end effector of FIG. 3, with an exemplary buttressdisposed above and on an exterior top surface of the staple cartridge;

FIG. 14 depicts an elevational view of the end effector of FIG. 3 andthe buttress of FIG. 13 disposed on and between an underside of theanvil and the exterior top surface of the staple cartridge;

FIG. 15 depicts a perspective view of an end effector with the buttressof FIG. 13, the end effector having fired and released staples and thebuttress of FIG. 13 into and onto the tissue;

FIG. 16 depicts a partial perspective view of an exemplary variation ofthe end effector of FIG. 3, with a portion of the end effector cut awayto reveal a wedge sled equipped with a rotatable secondary cuttingblade;

FIG. 17 depicts a cross-sectional view of the wedge sled of FIG. 16,taken along line 17-17 of FIG. 16, with the secondary cutting blade inan extended position;

FIG. 18 depicts a partial perspective view of another exemplaryvariation of the end effector of FIG. 3, with a portion of the endeffector cut away to reveal a wedge sled equipped with a fixed secondarycutting blade;

FIG. 19 depicts a side cross-sectional view of the wedge sled of FIG.18, taken along line 19-19 of FIG. 18, with the wedge sled in a proximalposition;

FIG. 20 depicts a side cross-sectional view of the wedge sled of FIG.18, taken along line 19-19 of FIG. 18, with the wedge sled in a distalposition;

FIG. 21 depicts a side cross-sectional view of an exemplary variation ofthe wedge sled of FIG. 18;

FIG. 22 depicts a perspective view of another exemplary wedge sled foruse with the end effector of FIG. 3, the wedge sled having a upwardlytranslatable secondary cutting blade;

FIG. 23 depicts a side cross-sectional view of the wedge sled of FIG.22, taken along line 23-23 of FIG. 22, with the secondary cutting bladein a retracted position;

FIG. 24 depicts a side cross-sectional view of the wedge sled of FIG.22, taken along line 23-23 of FIG. 22, with the secondary cutting bladein an extended position;

FIG. 25 depicts a perspective view of another exemplary wedge sled foruse with the end effector of FIG. 3, the wedge sled having a fixedsecondary cutting blade with a stabilizing nose; and

FIG. 26 depicts a side cross-sectional view of the wedge sled of FIG. 25taken along line 26-26 of FIG. 25, with the secondary cutting bladeadvanced distally.

The drawings are not intended to be limiting in any way, and it iscontemplated that various embodiments of the invention may be carriedout in a variety of other ways, including those not necessarily depictedin the drawings. The accompanying drawings incorporated in and forming apart of the specification illustrate several aspects of the presentinvention, and together with the description serve to explain theprinciples of the invention; it being understood, however, that thisinvention is not limited to the precise arrangements shown.

DETAILED DESCRIPTION

The following description of certain examples of the invention shouldnot be used to limit the scope of the present invention. Other examples,features, aspects, embodiments, and advantages of the invention willbecome apparent to those skilled in the art from the followingdescription, which is by way of illustration, one of the best modescontemplated for carrying out the invention. As will be realized, theinvention is capable of other different and obvious aspects, all withoutdeparting from the invention. Accordingly, the drawings and descriptionsshould be regarded as illustrative in nature and not restrictive.

I. Exemplary Surgical Stapler

FIG. 1 depicts an exemplary surgical stapling and severing instrument(10) that includes a handle assembly (20), a shaft assembly (30), and anend effector (40). End effector (40) and the distal portion of shaftassembly (30) are sized for insertion, in a nonarticulated state asdepicted in FIG. 1, through a trocar cannula to a surgical site in apatient for performing a surgical procedure. By way of example only,such a trocar may be inserted in a patient's abdomen, between two of thepatient's ribs, or elsewhere. In some settings, instrument (10) is usedwithout a trocar. For instance, end effector (40) and the distal portionof shaft assembly (30) may be inserted directly through a thoracotomy orother type of incision. It should be understood that terms such as“proximal” and “distal” are used herein with reference to a cliniciangripping handle assembly (20) of instrument (10). Thus, end effector(40) is distal with respect to the more proximal handle assembly (20).It will be further appreciated that for convenience and clarity, spatialterms such as “vertical” and “horizontal” are used herein with respectto the drawings. However, surgical instruments are used in manyorientations and positions, and these terms are not intended to belimiting and absolute.

A. Exemplary Handle Assembly and Shaft Assembly

As shown in FIGS. 1-2, handle assembly (20) of the present examplecomprises pistol grip (22), a closure trigger (24), and a firing trigger(26). Each trigger (24, 26) is selectively pivotable toward and awayfrom pistol grip (22) as will be described in greater detail below.Handle assembly (20) further includes an anvil release button (25), afiring beam reverse switch (27), and a removable battery pack (28).These components will also be described in greater detail below. Ofcourse, handle assembly (20) may have a variety of other components,features, and operabilities, in addition to or in lieu of any of thosenoted above. Other suitable configurations for handle assembly (20) willbe apparent to those of ordinary skill in the art in view of theteachings herein.

As shown in FIGS. 1-3, shaft assembly (30) of the present examplecomprises an outer closure tube (32), an articulation section (34), anda closure ring (36), which is further coupled with end effector (40).Closure tube (32) extends along the length of shaft assembly (30).Closure ring (36) is positioned distal to articulation section (34).Closure tube (32) and closure ring (36) are configured to translatelongitudinally relative to handle assembly (20). Longitudinaltranslation of closure tube (32) is communicated to closure ring (36)via articulation section (34). Exemplary features that may be used toprovide longitudinal translation of closure tube (32) and closure ring(36) will be described in greater detail below.

Articulation section (34) is operable to laterally deflect closure ring(36) and end effector (40) laterally away from the longitudinal axis(LA) of shaft assembly (30) at a desired angle (a). End effector (40)may thereby reach behind an organ or approach tissue from a desiredangle or for other reasons. In some versions, articulation section (34)enables deflection of end effector (40) along a single plane. In someother versions, articulation section (34) enables deflection of endeffector along more than one plane. In the present example, articulationis controlled through an articulation control knob (35) which is locatedat the proximal end of shaft assembly (30). Knob (35) is rotatable aboutan axis that is perpendicular to the longitudinal axis (LA) of shaftassembly (30). Closure ring (36) and end effector (40) pivot about anaxis that is perpendicular to the longitudinal axis (LA) of shaftassembly (30) in response to rotation of knob (35). By way of exampleonly, rotation of knob (35) clockwise may cause corresponding clockwisepivoting of closure ring (36) and end effector (40) at articulationsection (34). Articulation section (34) is configured to communicatelongitudinal translation of closure tube (32) to closure ring (36),regardless of whether articulation section (34) is in a straightconfiguration or an articulated configuration.

In some versions, articulation section (34) and/or articulation controlknob (35) are/is constructed and operable in accordance with at leastsome of the teachings of U.S. patent application Ser. No. 13/780,067,entitled SURGICAL INSTRUMENT END EFFECTOR ARTICULATION DRIVE WITH PINIONAND OPPOSING RACKS, filed Feb. 28, 2013, now U.S. Pat. No. 9,186,142,the disclosure of which is incorporated by reference herein.Articulation section (34) may also be constructed and operable inaccordance with at least some of the teachings of U.S. patentapplication Ser. No. 14/314,125, entitled ARTICULATION DRIVE FEATURESFOR SURGICAL STAPLER, filed Jun. 25, 2014, now U.S. Pat. No. 10,292,701,the disclosure of which is incorporated by reference herein; and/or inaccordance with the various teachings below. Other suitable forms thatarticulation section (34) and articulation knob (35) may take will beapparent to those of ordinary skill in the art in view of the teachingsherein.

As shown in FIGS. 1-2, shaft assembly (30) of the present examplefurther includes a rotation knob (31). Rotation knob (31) is operable torotate the entire shaft assembly (30) and end effector (40) relative tohandle assembly (20) about the longitudinal axis (LA) of shaft assembly(30). In some versions, rotation knob (31) is operable to selectivelylock the angular position of shaft assembly (30) and end effector (40)relative to handle assembly (20) about the longitudinal axis (LA) ofshaft assembly (30). For instance, rotation knob (31) may betranslatable between a first longitudinal position, in which shaftassembly (30) and end effector (40) are rotatable relative to handleassembly (20) about the longitudinal axis (LA) of shaft assembly (30);and a second longitudinal position, in which shaft assembly (30) and endeffector (40) are not rotatable relative to handle assembly (20) aboutthe longitudinal axis (LA) of shaft assembly (30). Of course, shaftassembly (30) may have a variety of other components, features, andoperabilities, in addition to or in lieu of any of those noted above. Byway of example only, at least part of shaft assembly (30) is constructedin accordance with at least some of the teachings of U.S. patentapplication Ser. No. 13/780,402, entitled SURGICAL INSTRUMENT WITHMULTI-DIAMETER SHAFT, filed Feb. 28, 2013, now U.S. Pat. No. 9,795,379,the disclosure of which is incorporated by reference herein. Othersuitable configurations for shaft assembly (30) will be apparent tothose of ordinary skill in the art in view of the teachings herein.

B. Exemplary End Effector

As also shown in FIGS. 1-3, end effector (40) of the present exampleincludes a lower jaw (50) and a pivotable anvil (60). Anvil (60)includes a pair of integral, outwardly extending pins (66) that aredisposed in corresponding curved slots (54) of lower jaw (50). Pins (66)and slots (54) are shown in FIG. 5. Anvil (60) is pivotable toward andaway from lower jaw (50) between an open position (shown in FIGS. 2 and4) and a closed position (shown in FIGS. 1, 3, and 7A-7B). Use of theterm “pivotable” (and similar terms with “pivot” as a base) should notbe read as necessarily requiring pivotal movement about a fixed axis.For instance, in the present example, anvil (60) pivots about an axisthat is defined by pins (66), which slide along curved slots (54) oflower jaw (50) as anvil (60) moves toward lower jaw (50). In suchversions, the pivot axis translates along the path defined by slots (54)while anvil (60) simultaneously pivots about that axis. In addition orin the alternative, the pivot axis may slide along slots (54) first,with anvil (60) then pivoting about the pivot axis after the pivot axishas slid a certain distance along the slots (54). It should beunderstood that such sliding/translating pivotal movement is encompassedwithin terms such as “pivot,” “pivots,” “pivotal,” “pivotable,”“pivoting,” and the like. Of course, some versions may provide pivotalmovement of anvil (60) about an axis that remains fixed and does nottranslate within a slot or channel, etc.

As best seen in FIG. 5, lower jaw (50) of the present example defines achannel (52) that is configured to receive a staple cartridge (70).Staple cartridge (70) may be inserted into channel (52), end effector(40) may be actuated, and then staple cartridge (70) may be removed andreplaced with another staple cartridge (70). Lower jaw (50) thusreleasably retains staple cartridge (70) in alignment with anvil (60)for actuation of end effector (40). In some versions, lower jaw (50) isconstructed in accordance with at least some of the teachings of U.S.patent application Ser. No. 13/780,417, entitled INSTALLATION FEATURESFOR SURGICAL INSTRUMENT END EFFECTOR CARTRIDGE, filed Feb. 28, 2013, nowU.S. Pat. No. 9,808,248, the disclosure of which is incorporated byreference herein. Other suitable forms that lower jaw (50) may take willbe apparent to those of ordinary skill in the art in view of theteachings herein.

As best seen in FIGS. 4-6, staple cartridge (70) of the present examplecomprises a cartridge body (71) and a tray (76) secured to the undersideof cartridge body (71). The upper side of cartridge body (71) presents adeck (73), against which tissue may be compressed when anvil (60) is ina closed position. Cartridge body (71) further defines a longitudinallyextending channel (72) and a plurality of staple pockets (74). A staple(77) is positioned in each staple pocket (74). A staple driver (75) isalso positioned in each staple pocket (74), underneath a correspondingstaple (77), and above tray (76). As will be described in greater detailbelow, staple drivers (75) are operable to translate upwardly in staplepockets (74) to thereby drive staples (77) upwardly through staplepockets (74) and into engagement with anvil (60). Staple drivers (75)are driven upwardly by a wedge sled (78), which is captured betweencartridge body (71) and tray (76), and which translates longitudinallythrough cartridge body (71). Wedge sled (78) includes a pair ofobliquely angled cam surfaces (79), which are configured to engagestaple drivers (75) and thereby drive staple drivers (75) upwardly aswedge sled (78) translates longitudinally through cartridge (70). Forinstance, when wedge sled (78) is in a proximal position as shown inFIG. 7A, staple drivers (75) are in downward positions and staples (77)are located in staple pockets (74). As wedge sled (78) is driven to thedistal position shown in FIG. 7B by a translating knife member (80),wedge sled (78) drives staple drivers (75) upwardly, thereby drivingstaples (77) out of staple pockets (74) and into staple forming pockets(64). Thus, staple drivers (75) translate along a vertical dimension aswedge sled (78) translates along a horizontal dimension.

It should be understood that the configuration of staple cartridge (70)may be varied in numerous ways. For instance, staple cartridge (70) ofthe present example includes two longitudinally extending rows of staplepockets (74) on one side of channel (72); and another set of twolongitudinally extending rows of staple pockets (74) on the other sideof channel (72). However, in some other versions, staple cartridge (70)includes three, one, or some other number of staple pockets (74) on eachside of channel (72). In some versions, staple cartridge (70) isconstructed and operable in accordance with at least some of theteachings of U.S. patent application Ser. No. 13/780,106, entitledINTEGRATED TISSUE POSITIONING AND JAW ALIGNMENT FEATURES FOR SURGICALSTAPLER, filed Feb. 28, 2013, now U.S. Pat. No. 9,517,065, thedisclosure of which is incorporated by reference herein. In addition orin the alternative, staple cartridge (70) may be constructed andoperable in accordance with at least some of the teachings of U.S.patent application Ser. No. 13/780,417, entitled INSTALLATION FEATURESFOR SURGICAL INSTRUMENT END EFFECTOR CARTRIDGE, filed Feb. 28, 2013, nowU.S. Pat. No. 9,808,248, the disclosure of which is incorporated byreference herein. Other suitable forms that staple cartridge (70) maytake will be apparent to those of ordinary skill in the art in view ofthe teachings herein.

As best seen in FIG. 4, anvil (60) of the present example comprises alongitudinally extending channel (62) and a plurality of staple formingpockets (64). Channel (62) is configured to align with channel (72) ofstaple cartridge (70) when anvil (60) is in a closed position. Eachstaple forming pocket (64) is positioned to lie over a correspondingstaple pocket (74) of staple cartridge (70) when anvil (60) is in aclosed position. Staple forming pockets (64) are configured to deformthe legs of staples (77) when staples (77) are driven through tissue andinto anvil (60). In particular, staple forming pockets (64) areconfigured to bend the legs of staples (77) to secure the formed staples(77) in the tissue. Anvil (60) may be constructed in accordance with atleast some of the teachings of U.S. patent application Ser. No.13/780,106, entitled INTEGRATED TISSUE POSITIONING AND JAW ALIGNMENTFEATURES FOR SURGICAL STAPLER, filed Feb. 28, 2013, now U.S. Pat. No.9,517,065; at least some of the teachings of U.S. patent applicationSer. No. 13/780,120, entitled JAW CLOSURE FEATURE FOR END EFFECTOR OFSURGICAL INSTRUMENT, filed Feb. 28, 2013, now U.S. Pat. No. 9,839,421;and/or at least some of the teachings of U.S. patent application Ser.No. 13/780,379, entitled STAPLE FORMING FEATURES FOR SURGICAL STAPLINGINSTRUMENT, filed Feb. 28, 2013, now U.S. Pat. No. 10,092,292, thedisclosure of which is incorporated by reference herein. Other suitableforms that anvil (60) may take will be apparent to those of ordinaryskill in the art in view of the teachings herein.

In the present example, a knife member (80) is configured to translatethrough end effector (40). As best seen in FIGS. 5 and 7A-7B, knifemember (80) is secured to the distal end of a firing beam (82), whichextends through a portion of shaft assembly (30). As best seen in FIGS.4 and 6, knife member (80) is positioned in channels (62, 72) of anvil(60) and staple cartridge (70). Knife member (80) includes a distallypresented cutting edge (84) that is configured to sever tissue that iscompressed between anvil (60) and deck (73) of staple cartridge (70) asknife member (80) translates distally through end effector (40). Asnoted above and as shown in FIGS. 7A-7B, knife member (80) also driveswedge sled (78) distally as knife member (80) translates distallythrough end effector (40), thereby driving staples (77) through tissueand against anvil (60) into formation. Various features that may be usedto drive knife member (80) distally through end effector (40) will bedescribed in greater detail below.

In some versions, end effector (40) includes lockout features that areconfigured to prevent knife member (80) from advancing distally throughend effector (40) when a staple cartridge (70) is not inserted in lowerjaw (50). In addition or in the alternative, end effector (40) mayinclude lockout features that are configured to prevent knife member(80) from advancing distally through end effector (40) when a staplecartridge (70) that has already been actuated once (e.g., with allstaples (77) deployed therefrom) is inserted in lower jaw (50). By wayof example only, such lockout features may be configured in accordancewith at least some of the teachings of U.S. patent application Ser. No.13/780,082, entitled LOCKOUT FEATURE FOR MOVABLE CUTTING MEMBER OFSURGICAL INSTRUMENT, filed Feb. 28, 2013, now U.S. Pat. No. 9,717,497,the disclosure of which is incorporated by reference herein; and/or atleast some of the teachings of U.S. patent application Ser. No.14/314,108, entitled METHOD OF USING LOCKOUT FEATURES FOR SURGICALSTAPLER CARTRIDGE, filed on Jun. 25, 2014, now U.S. Pat. No. 10,335,147,the disclosure of which is incorporated by reference herein. Othersuitable forms that lockout features may take will be apparent to thoseof ordinary skill in the art in view of the teachings herein.Alternatively, end effector (40) may simply omit such lockout features.

C. Exemplary Actuation of Anvil

In the present example, anvil (60) is driven toward lower jaw (50) byadvancing closure ring (36) distally relative to end effector (40).Closure ring (36) cooperates with anvil (60) through a camming action todrive anvil (60) toward lower jaw (50) in response to distal translationof closure ring (36) relative to end effector (40). Similarly, closurering (36) may cooperate with anvil (60) to open anvil (60) away fromlower jaw (50) in response to proximal translation of closure ring (36)relative to end effector (40). By way of example only, closure ring (36)and anvil (60) may interact in accordance with at least some of theteachings of U.S. patent application Ser. No. 13/780,120, entitled JAWCLOSURE FEATURE FOR END EFFECTOR OF SURGICAL INSTRUMENT, filed Feb. 28,2013, now U.S. Pat. No. 9,839,421, the disclosure of which isincorporated by reference herein; and/or in accordance with at leastsome of the teachings of U.S. patent application Ser. No. 14/314,108,entitled JAW OPENING FEATURE FOR SURGICAL STAPLER, filed on Jun. 25,2014, now U.S. Pat. No. 10,335,147, the disclosure of which isincorporated by reference herein. Exemplary features that may be used toprovide longitudinal translation of closure ring (36) relative to endeffector (40) will be described in greater detail below.

As noted above, handle assembly (20) includes a pistol grip (22) and aclosure trigger (24). As also noted above, anvil (60) is closed towardlower jaw (50) in response to distal advancement of closure ring (36).In the present example, closure trigger (24) is pivotable toward pistolgrip (22) to drive closure tube (32) and closure ring (36) distally.Various suitable components that may be used to convert pivotal movementof closure trigger (24) toward pistol grip (22) into distal translationof closure tube (32) and closure ring (36) relative to handle assembly(20) will be apparent to those of ordinary skill in the art in view ofthe teachings herein. When closure trigger (24) reaches a fully pivotedstate, such that anvil (60) is in a fully closed position relative tolower jaw (50), locking features in handle assembly (20) lock theposition of trigger (24) and closure tube (32), thereby locking anvil(60) in a fully closed position relative to lower jaw (50). Theselocking features are released by actuation of anvil release button (25).Anvil release button (25) is configured and positioned to be actuated bythe thumb of the operator hand that grasps pistol grip (22). In otherwords, the operator may grasp pistol grip (22) with one hand, actuateclosure trigger (24) with one or more fingers of the same hand, and thenactuate anvil release button (25) with the thumb of the same hand,without ever needing to release the grasp of pistol grip (22) with thesame hand. Other suitable features that may be used to actuate anvil(60) will be apparent to those of ordinary skill in the art in view ofthe teachings herein.

D. Exemplary Actuation of Firing Beam

In the present example, instrument (10) provides motorized control offiring beam (82). FIGS. 9-12 show exemplary components that may be usedto provide motorized control of firing beam (82). In particular, FIG. 9shows an exemplary control circuit (100) that may be used to power anelectric motor (102) with electric power from a battery pack (28) (alsoshown in FIGS. 1-2). Electric motor (102) is operable to translatefiring beam (82) longitudinally as will be described in greater detailbelow. It should be understood that the entire control circuit (100),including motor (102) and battery pack (28), may be housed within handleassembly (20). FIG. 9 shows firing trigger (26) as an open switch,though it should be understood that this switch is closed when firingtrigger (26) is actuated. Circuit (100) of this example also includes asafety switch (106) that must be closed in order to complete circuit(100), though it should be understood that safety switch (106) is merelyoptional. Safety switch (106) may be closed by actuating a separatebutton, slider, or other feature on handle assembly (20). Safety switch(106) may also provide a mechanical lockout of firing trigger (26), suchthat firing trigger (26) is mechanically blocked from actuation untilsafety switch (106) is actuated.

Circuit (100) of the present example also includes a lockout switch(108), which is configured to be closed by default but is automaticallyopened in response to a lockout condition. By way of example only, alockout condition may include one or more of the following: the absenceof a cartridge (70) in lower jaw (50), the presence of a spent (e.g.,previously fired) cartridge (70) in lower jaw (50), an insufficientlyclosed anvil (60), a determination that instrument (10) has been firedtoo many times, and/or any other suitable conditions. Various sensors,algorithms, and other features that may be used to detect lockoutconditions will be apparent to those of ordinary skill in the art inview of the teachings herein. Similarly, other suitable kinds of lockoutconditions will be apparent to those of ordinary skill in the art inview of the teachings herein. It should be understood that circuit (100)is opened and thus motor (102) is inoperable when lockout switch (108)is opened. A lockout indicator (110) (e.g., an LED, etc.) is operable toprovide a visual indication of the status of lockout switch (108). Byway of example only, lockout switch (108), lockout indicator (110), andassociated components/functionality may be configured in accordance withat least some of the teachings of U.S. Pat. No. 7,644,848, entitledELECTRONIC LOCKOUTS AND SURGICAL INSTRUMENT INCLUDING SAME, issued Jan.12, 2010, the disclosure of which is incorporated by reference herein.

Once firing beam (82) reaches a distal-most position (e.g., at the endof a cutting stroke), an end-of-stroke switch (112) is automaticallyswitched to a closed position, reversing the polarity of the voltageapplied to motor (102). This reverses the direction of rotation of motor(102), it being understood that the operator will have released firingtrigger (26) at this stage of operation. In this operational state,current flows through a reverse direction indicator (114) (e.g., an LED,etc.) to provide a visual indication to the operator that motor (102)rotation has been reversed. In the present example, and as best seen inFIG. 12, a switch actuation arm (134) extends laterally from rack member(130), and is positioned to engage end-of-stroke switch (112) whenfiring beam (82) reaches a distal-most position (e.g., after tissue (90)has been severed and staples (77) have been driven into tissue (90)).Various other suitable ways in which end-of-stroke switch (112) may beautomatically switched to a closed position when firing beam (82)reaches a distal-most position will be apparent to those of ordinaryskill in the art in view of the teachings herein. Similarly, varioussuitable forms that reverse direction indicator (114) may take will beapparent to those of ordinary skill in the art in view of the teachingsherein.

Handle assembly (20) of the present example also includes a manualreturn switch (116), which is also shown in circuit (100). In thepresent example, return switch is activated by actuating reverse switch(27), which is shown on handle assembly (20) in FIG. 1. Manual returnswitch (116) may provide functionality similar to end-of-stroke switch(112), reversing the polarity of the voltage applied to motor (102) tothereby reverse the direction of rotation of motor (102). Again, thisreversal may be visually indicated through reverse direction indicator(114). In some versions, handle assembly (20) further includes amechanical return feature that enables the operator to manually reversefiring beam (82) and thereby retract firing beam (82) mechanically. Inthe present example, this manual return feature comprises a lever thatis covered by a removable panel (21) as shown in FIG. 1. Manual returnswitch (116) and the mechanical return feature are each configured toact as a “bailout” feature, enabling the operator to quickly beginretracting firing beam (82) proximally during a firing stroke. In otherwords, manual return switch (116) or the mechanical return feature maybe actuated when firing beam (82) has only been partially advanceddistally.

In some versions, one or more of switches (26, 106, 108, 112, 116) arein the form of microswitches. Other suitable forms will be apparent tothose of ordinary skill in the art in view of the teachings herein. Inaddition to or in lieu of the foregoing, at least part of circuit (100)may be configured in accordance with at least some of the teachings ofU.S. Pat. No. 8,210,411, entitled MOTOR-DRIVEN SURGICAL INSTRUMENT,issued Jul. 3, 2012, the disclosure of which is incorporated byreference herein.

FIG. 10 shows motor (102) positioned within pistol grip (22) of handleassembly (20). Alternatively, motor (102) may be positioned elsewherewithin handle assembly (20). Motor (102) has a drive shaft (120) that iscoupled with a gear assembly (122). Thus, when motor (102) is activated,drive shaft (120) actuates gear assembly (122). As shown in FIG. 11,gear assembly (122) is in communication with a drive gear (124), whichmeshes with an idler pinion (126). Pinion (126) is disposed on a shaft(128) that is supported within handle assembly (20) and that is orientedparallel to drive shaft (120) of motor (102). Pinion (126) is furtherengaged with a rack member (130). In particular, pinion (126) mesheswith teeth (132) at the proximal end of rack member (130). Rack member(130) is slidably supported in handle assembly (20). It should beunderstood from the foregoing that, when motor (102) is activated, thecorresponding rotation of drive shaft (120) is communicated to pinion(126) via gear assembly (122), and the corresponding rotation of pinion(126) is converted to translation of rack member (130) by teeth (132).As shown in FIGS. 10-12, an elongate member (136) extends distally fromrack member (130). As shown in FIG. 12, a coupling member (138) joinsfiring beam (82) with elongate member (136). Rack member (130), elongatemember (136), coupling member (138), firing beam (82), and knife member(80) all translate together relative to handle assembly (20) in responseto activation of motor (102). In other words, activation of motor (102)ultimately causes firing beam (82) to translate longitudinally, thedirection of such translation depending on the direction of rotation ofdrive shaft (120).

It should be understood that a distal portion of elongate member (136),coupling member (138), and firing beam (82) extend through shaftassembly (30). A portion of firing beam (82) also extends througharticulation section (34). In some versions, rack member (130), elongatemember (136), and coupling member (138) are all substantially straightand rigid; while firing beam (82) has sufficient flexibility to bend atarticulation section (34) and translate longitudinally througharticulation section (34) when articulation section (34) is in a bent orarticulated state.

In addition to or in lieu of the foregoing, the features operable todrive firing beam (82) may be configured in accordance with at leastsome of the teachings of U.S. Pat. No. 8,453,914, the disclosure ofwhich is incorporated by reference herein. Other suitable components,features, and configurations for providing motorization of firing beam(82) will be apparent to those of ordinary skill in the art in view ofthe teachings herein. It should also be understood that some otherversions may provide manual driving of firing beam (82), such that amotor may be omitted. By way of example only, firing beam (82) may beactuated in accordance with at least some of the teachings of any otherreference cited herein.

FIG. 8 shows end effector (40) having been actuated through a singlestroke through tissue (90). As shown, cutting edge (84) (obscured inFIG. 8) has cut through tissue (90), while staple drivers (75) havedriven two alternating rows of staples (77) through the tissue (90) oneach side of the cut line produced by cutting edge (84). Staples (77)are all oriented substantially parallel to the cut line in this example,though it should be understood that staples (77) may be positioned atany suitable orientations. In the present example, end effector (40) iswithdrawn from the trocar after the first stroke is complete, the spentstaple cartridge (70) is replaced with a new staple cartridge (70), andend effector (40) is then again inserted through the trocar to reach thestapling site for further cutting and stapling. This process may berepeated until the desired amount of cuts and staples (77) have beenprovided. Anvil (60) may need to be closed to facilitate insertion andwithdrawal through the trocar; and anvil (60) may need to be opened tofacilitate replacement of staple cartridge (70).

It should be understood that cutting edge (84) may sever tissuesubstantially contemporaneously with staples (77) being driven throughtissue during each actuation stroke. In the present example, cuttingedge (84) just slightly lags behind driving of staples (77), such that astaple (47) is driven through the tissue just before cutting edge (84)passes through the same region of tissue, though it should be understoodthat this order may be reversed or that cutting edge (84) may bedirectly synchronized with adjacent staples (77). While FIG. 8 shows endeffector (40) being actuated in two layers (92, 94) of tissue (90), itshould be understood that end effector (40) may be actuated through asingle layer of tissue (90) or more than two layers (92, 94) of tissue.It should also be understood that the formation and positioning ofstaples (77) adjacent to the cut line produced by cutting edge (84) maysubstantially seal the tissue at the cut line, thereby reducing orpreventing bleeding and/or leaking of other bodily fluids at the cutline. Furthermore, while FIG. 8 shows end effector (40) being actuatedin two substantially flat, apposed planar layers (92, 94) of tissue, itshould be understood that end effector (40) may also be actuated acrossa tubular structure such as a blood vessel, a section of thegastrointestinal tract, etc. FIG. 8 should therefore not be viewed asdemonstrating any limitation on the contemplated uses for end effector(40). Various suitable settings and procedures in which instrument (10)may be used will be apparent to those of ordinary skill in the art inview of the teachings herein.

It should also be understood that any other components or features ofinstrument (10) may be configured and operable in accordance with any ofthe various references cited herein. Additional exemplary modificationsthat may be provided for instrument (10) will be described in greaterdetail below. Various suitable ways in which the below teachings may beincorporated into instrument (10) will be apparent to those of ordinaryskill in the art. Similarly, various suitable ways in which the belowteachings may be combined with various teachings of the references citedherein will be apparent to those of ordinary skill in the art. It shouldalso be understood that the below teachings are not limited toinstrument (10) or devices taught in the references cited herein. Thebelow teachings may be readily applied to various other kinds ofinstruments, including instruments that would not be classified assurgical staplers. Various other suitable devices and settings in whichthe below teachings may be applied will be apparent to those of ordinaryskill in the art in view of the teachings herein.

II. Exemplary Alternative Staple Cartridge

FIGS. 13-14 show an exemplary alternative staple cartridge (270) thatmay be inserted into lower jaw (50) of end effector (40). Other than asset forth below, staple cartridge (270) of this example is substantiallysimilar to staple cartridge (70) as described above. For instance,cartridge (270), like cartridge (70) comprises a cartridge body (271)and tray (not shown) secured to the underside of cartridge body (271).Similarly, the upper side of cartridge body (271) presents a deck (273),against which tissue may be compressed when anvil (60) is in a closedposition.

Unlike cartridge (70), cartridge (270) equipped with a buttress (280)disposed on deck (273) of cartridge body (271). In the present example,buttress (280) comprises a strong yet flexible material configured tostructurally support a staple line. In addition or in the alternative,buttress (280) may be comprised of a material including, for example, ahemostatic agent such as fibrin to assist in coagulating blood andreduce bleeding at the severed and/or stapled surgical site along tissue(90).

In other examples, buttress (280) may comprise materials other thanthose discussed above. For example, other adjuncts or hemostatic agentssuch as thrombin may be used such that buttress (280) may assist tocoagulate blood and reduce the amount of bleeding at the surgical site.The hemostatic abilities of such adjuncts may also contribute to the useof such adjuncts as adhesives and sealants. The agents may assist tocoagulate blood at a surgical site which allows tissue surrounding suchblood to stick together and may prevent leaks along the stapled tissuesite, for example. Other adjuncts or reagents that may be incorporatedinto buttress (280) may further include but are not limited to medicalfluid or matrix components. By way of example only, buttress (280) mayinclude natural or genetically engineered absorbable polymers orsynthetic absorbable polymers, or mixtures thereof. Merely illustrativeexamples of natural or genetically engineered absorbable polymers areproteins, polysaccharides and combinations thereof. Merely illustrativeexamples of proteins that may be used include prothrombin, thrombin,fibrinogen, fibrin, fibronectin, heparinase, Factor X/Xa, FactorVII/VIla, Factor IX/IXa, Factor XI/XIa, Factor XII/XIIa, tissue factor,batroxobin, ancrod, ecarin, von Willebrand Factor, collagen, elastin,albumin, gelatin, platelet surface glycoproteins, vasopressin,vasopressin analogs, epinephrine, selectin, procoagulant venom,plasminogen activator inhibitor, platelet activating agents, syntheticpeptides having hemostatic activity, and/or combinations thereof.Polysaccharides include, without limitation, cellulose, alkyl cellulose,e.g. methylcellulose, alkylhydroxyalkyl cellulose, hydroxyalkylcellulose, cellulose sulfate, salts of carboxymethyl cellulose,carboxymethyl cellulose, carboxyethyl cellulose, chitin, carboxymethylchitin, hyaluronic acid, salts of hyaluronic acid, alginate, alginicacid, propylene glycol alginate, glycogen, dextran, dextran sulfate,curdlan, pectin, pullulan, xanthan, chondroitin, chondroitin sulfates,carboxymethyl dextran, carboxymethyl chitosan, chitosan, heparin,heparin sulfate, heparan, heparan sulfate, dermatan sulfate, keratansulfate, carrageenans, chitosan, starch, amylose, amylopectin,poly-N-glucosamine, polymannuronic acid, polyglucuronic acidpolyguluronic acid, and derivatives of any of the above. Examples ofsynthetic absorbable polymers are aliphatic polyester polymers,copolymers, and/or combinations thereof. The aliphatic polyesters aretypically synthesized in a ring opening polymerization of monomersincluding, but not limited to, lactic acid, lactide (including L-, D-,meso and D, L mixtures), glycolic acid, glycolide, ε-caprolactone,p-dioxanone (1,4-dioxan-2-one), and trimethylene carbonate(1,3-dioxan-2-one). Other suitable compounds, materials, substances,etc., that may be used in a medical fluid or matrix will be apparent tothose of ordinary skill in the art in view of the teachings herein.

Buttress (280) includes a cartridge portion (282), an anvil portion(284), and an intermediate portion (286) disposed between the proximalends of cartridge portion (282) and anvil portion (284). Anvil portion(284) includes flap (288) that wraps over the distal end of anvil (60),as shown in FIG. 14. Flap (288), for example, defines a pocket (notshown) sized for receipt of the distal end of anvil (60), to therebyattach anvil portion (284) of buttress (280) to anvil (60). Intermediateportion (286) of buttress (280) may comprise a preformed bend tofacilitate loading of cartridge (270) in lower jaw and insertion ofanvil (60) in the pocket defined by flap (288).

Cartridge (270) further includes fasteners such as hooks (290) thatgrasp onto buttress (280). Hooks (290) and buttress (280) may provide afastening relationship, such as a hook and loop fastening relationshipin which hooks (290) connect to loops formed within the material ofbuttress (280). Although the present example is shown as having hooks(290), it should be understood that any other suitable means may be usedto fasten cartridge portion (282) of buttress (280) to deck (273) ofcartridge (270).

In use, cartridge (270) with buttress (280) is removably received intolower jaw (50) of end effector (40), as shown in FIG. 13. When endeffector (40) including cartridge (270) and buttress (280) is used, asshown in FIG. 15, staples (277) are driven into tissue (90) concurrentlyor slightly prior to firing beam (82) cutting through tissue (90) whilealso cutting through buttress (280). Staples (277) may capture portionsof buttress (280) and drive those portions into tissue (90) or at leastsecure buttress (280) to tissue (90). Firing beam (82) slices throughbuttress (280) as it severs tissue (90) in use, applying material frombuttress (280) onto severed tissue.

While buttress (280) is shown as having a certain configuration, itshould be understood that the precise configuration of buttress (280)may be varied. For instance, in some versions, a medical fluid may besuspended in a biocompatible carrier. Suitable carriers may include, forexample, a physiological buffer solution, a flowable gel solution,saline, and water. In the case of gel solutions, the tissue repaircomposition may be in a flowable gel form prior to delivery at thetarget site, or may form a gel and remain in place after delivery at thetarget site. Flowable gel solutions may comprise one or more gellingmaterials with or without added water, saline, or a physiological buffersolution. Exemplary gelling materials include proteins, polysaccharides,polynucleotides, and other materials such as alginate, cross-linkedalginate, poly(N-isopropylacrylamide), poly(oxyalkylene), copolymers ofpoly(ethylene oxide)-poly(propylene oxide), poly(vinyl alcohol),polyacrylate, or monostearoyl glycerol co-Succinate/polyethylene glycol(MGSA/PEG) copolymers, and combinations of any of the foregoing.

Buttress (280) may alternatively comprise a fibrous pad, a foam, a mesh,or another structure capable of containing an adhesive or other type ofmedical fluid. By way of example only, cartridge (270) and/or buttress(280) may be constructed in accordance with the teachings of U.S. PatentApplication Publication No. 2013/0068816, entitled SURGICAL INSTRUMENTAND BUTTRESS MATERIAL, published Mar. 21, 2013; U.S. Patent ApplicationPublication No. 2013/0062391, entitled SURGICAL INSTRUMENT WITH FLUIDFILLABLE BUTTRESS, published Mar. 14, 2013, now U.S. Pat. No. 9,999,408;U.S. Patent Application Publication No. 2013/0068820, entitled FIBRINPAD MATRIX WITH SUSPENDED HEAT ACTIVATED BEADS OF ADHESIVE, publishedMar. 21, 2013, now U.S. Pat. No. 8,814,025; U.S. Patent ApplicationPublication No. 2013/0082086, entitled ATTACHMENT OF SURGICAL STAPLEBUTTRESS TO CARTRIDGE, published Apr. 4, 2013, now U.S. Pat. No.8,899,464; U.S. Patent Application Publication No. 2013/0037596,entitled DEVICE FOR APPLYING ADJUNCT IN ENDOSCOPIC PROCEDURE, publishedFeb. 14, 2013, now U.S. Pat. No. 9,492,170; U.S. Patent ApplicationPublication No. 2013/0062393, entitled RESISTIVE HEATED SURGICAL STAPLECARTRIDGE WITH PHASE CHANGE SEALANT, published Mar. 14, 2013, now U.S.Pat. No. 8,998,060; U.S. Patent Application Publication No.2013/0075446, entitled SURGICAL STAPLE ASSEMBLY WITH HEMOSTATIC FEATURE,published Mar. 28, 2013, now U.S. Pat. No. 9,393,018; U.S. PatentApplication Publication No. 2013/0062394, entitled SURGICAL STAPLECARTRIDGE WITH SELF-DISPENSING STAPLE BUTTRESS, published Mar. 14, 2013,now U.S. Pat. No. 9,101,359; U.S. Patent Application Publication No.2013/0075445, entitled ANVIL CARTRIDGE FOR SURGICAL FASTENING DEVICE,published Mar. 28, 2013, now U.S. Pat. No. 9,198,644; and U.S. PatentApplication Publication No. 2013/0075447, entitled ADJUNCT THERAPY FORAPPLYING HEMOSTATIC AGENT, published Mar. 28, 2013, the disclosure ofwhich is incorporated by reference herein.

III. Exemplary Alternative Wedge Sleds

In some instances, it may be desirable to provide additional and/oralternative structures and for cutting tissue and/or buttresses (280).For instance, in some examples instrument (10) itself may be reusablewhile cartridge (70, 270) may be disposable. Because of this, repeatedreuse of instrument (10) may cause cutting edge (84) of firing beam (82)to become dull. Such dulling may be intensified by the use of acartridge (270) that includes a buttress (280) similar to thosediscussed above. In addition or in the alternative, cutting edge (84)and/or other portions of firing beam (82) may encounter a buildup ofmaterial that forms buttress (280) as the same firing beam (82) is firedthrough a plurality of buttresses (280). Such a buildup of material mayadversely impact the ability of firing beam (82) to sever tissue and/oradditional buttresses (280). In additional or in the alternative, such abuildup of material may provide increased friction or interference thatrequires additional force to drive firing beam (82) distally. Variousexamples of additional and/or alternative structures that may be used toprovide at least some disposable cutting feature(s) are described ingreater detail below, while other examples will be apparent to those ofordinary skill in the art in view of the teachings herein.

A. Exemplary Wedge Sled with Rotatable Blade

FIG. 16 shows a perspective cutaway view of lower jaw (50) and analternative staple cartridge (370). Staple cartridge (370) may be usedas a substitute for staple cartridge (70). In addition, or inalternative, staple cartridge (370) may include a buttress (280) likestaple cartridge (270) or any other kind of buttress, including but notlimited to the various buttresses described in the various referencescited herein. Staple cartridge (370) is substantially similar to staplecartridges (70, 270) described above with the primary difference beingthat staple cartridge (370) is equipped with an exemplary alternativewedge sled (378). Wedge sled (378) is similar to wedge sled (78)described above. In the present example, wedge sled (378) has beenmodified relative to wedge sled (78) to accommodate a secondary cuttingblade (380) that is rotatable into wedge sled (378). In particular, asshown in FIGS. 16-17, wedge sled (378) includes a body (377) a pluralityof cam surfaces (379). Body (377) defines a blade slot (382). Body andcam surfaces (379) are shorter relative to cam surface (79) of wedgesled (78), yet body (377) and cam surfaces (379) are oriented at anangle that is steeper than the angle of cam surface (79) of wedge sled(78). Accordingly, wedge sled (378) occupies the same amount oflongitudinal space within cartridge (370) as wedge sled (78) incartridge (70, 270), making wedge sled (378) substantiallyinterchangeable with wedge sled (78). The angle of cam surfaces (379)permit wedge sled (378) to drive multiple staple drivers (75) upwardlysimultaneously and/or in a certain predetermined sequence.

Blade slot (382) is configured to accommodate the rotation of blade(380) within wedge sled (378). As can best be seen in FIG. 17, bladeslot (382) has a shape approximately corresponding to a shape defined byblade (380) rotating between a retracted position (shown in phantom) andan extended position. Additionally, blade slot (382) defines a stopfeature (383) which, as will be described in greater detail below,prevents blade from rotating proximally beyond the extended position.The shape of blade slot (382) further defines a proximal opening (384)in wedge sled (378). As will be described in greater detail below,proximal opening provides access to blade (380) such that blade may beactuated by firing beam (82) from a retracted position to an extendedposition. In other examples, blade slot (382) may have any othersuitable shape as will be apparent to those of ordinary skill in the artin view of the teachings herein.

As can be seen in FIG. 17, wedge sled (378) further comprises a rotationpin or shaft (385), which extends through blade slot (382). A throughhole (386) in blade (380) permits blade (380) to pivotably couple towedge sled (378) such that blade (380) can rotate distally to theretracted position. Although not shown in FIG. 17, it should beunderstood that rotation shaft (385) may be equipped with bushings,bearings, or other components or features suitable to aid rotation ofblade (380). Additionally, rotation shaft (385) may be equipped withcomponents or features such as springs suitable to resiliently biasblade (380) toward the retracted or extended position.

Blade (380) has a cross-sectional shape similar to a small knife. Inparticular, wither reference to blade (380) in the extended position,blade (380) has an upper cutting portion (388) and a lower attachmentportion (394). Upper cutting portion (388) comprises a distally facingangular cutting edge (390) and a proximally facing flat portion (392).Cutting edge (390) extends at an angle upwardly from attachment portion(394). Although cutting edge (390) comprises a straight edge extendingat an angle, it should be understood that cutting edge (390) may take onany other suitable shape. For instance, cutting edge (390) may becurved, serrated, saw toothed, and/or otherwise configured. Cutting edge(390) may further be angled differently relative to the angle shown.

Flat portion (392) extends upwardly from attachment portion (394). Likewith cutting edge (390), flat portion (392) need not be limited to theshape described herein. As will be described in greater detail below,flat portion (392) provides a surface that may engage with stop feature(383) of wedge sled (378).

Upper cutting portion (388) of blade (380) extends upwardly to a certainheight above wedge sled (378). In the present example, the height ofupper cutting portion (388) is configured to cut through both a buttress(280) and tissue (90). In other examples, upper cutting portion (388)may have a height that is less than the height depicted such that uppercutting portion (388) only cuts through a buttress (280) immediatelyadjacent to cartridge (370), without necessarily cutting through tissue(90) that is positioned above buttress (280). It should be understoodthat upper cutting portion (388), or the other elements of cuttingportion (388) described above, may be of any other suitable shape,height, or configuration as will be apparent to those of ordinary skillin the art in view of the teachings herein.

In an exemplary mode of operation, blade (380) is in the retractedposition prior to insertion of cartridge (370) into lower jaw (50). Inthe retracted position, blade (380) is recessed entirely insidecartridge (370) and wedge sled (378). Accordingly, an operator isprotected from inadvertent contact with blade (380) while insertingcartridge (70, 270) into lower jaw (50).

Once an operator has inserted cartridge (370) into lower jaw (50), blade(380) remains retracted until an operator initiates the firing sequence.Once the firing sequence is initiated, firing beam (82) is drivendistally such that knife member (80) contacts wedge sled (378). Knifemember (80) may include one or more protruding features (not shown)configured to engage blade (380) such that blade may be actuated intothe extended position, with stop feature (383) arresting furtherrotation. Alternatively, wedge sled (378) may be equipped with featuressuitable to actuate blade (380) upon knife member (80) contacting wedgesled (378). In the extended position, blade (380) extends through a deck(373) of cartridge (370).

With blade (380) in the extended position, firing beam (82) continues toadvance distally, driving cutting edge (390) of blade (380) through abuttress (280) (if equipped) and tissue (90). Cutting edge (84) of knifemember (80) may trail shortly behind blade (380), such that cutting edge(84) cuts any tissue (90) or buttress (280) material left uncut by blade(380). It should be understood that cutting edge (84) of knife member(80) and cutting edge (390) of blade (380) follow a path that issubstantially identical. Such a path may generally be defined by alongitudinally extending channel (372) of cartridge (370). By making thefirst cutting pass through buttress (280) (and in some versions, tissue(90) as well), blade (380) may reduce wear and/or buildup on knifemember (80), thereby prolonging the useful life of knife member (80).Additionally, it should be understood that both blade (380) and knifemember (80) trail cam surfaces (379) such that wedge sled (378) willdrive staples (77) through a given region of tissue before thatparticular region of tissue is cut by blade (380) or knife member (80).The stapling and cutting action may still be considered substantiallysimultaneous at that region of tissue because wedge sled (378) isconfigured such that the difference in timing between stapling andcutting is substantially short.

Once instrument (10) has been fired, cartridge (370) may be removedalong with blade (380) such that a new cartridge (370) and/or blade(380) may be inserted into lower jaw (50). It should be understood thatcartridge (370) may be replaced with an identical cartridge (370) or adifferent cartridge (70, 270, 370). For instance, some cartridges (370)may be equipped with blades (380) configured for different procedures.By way of example only, cartridge (370) may include a sharper blade(380) for use with lung tissue. Alternatively, cartridge (370) mayinclude a more robust blade (380) for use with stomach tissue. Ofcourse, cartridge (370) may include a blade (380) suitable to cutthrough any tissue as will be apparent to those of ordinary skill in theart in view of the teachings herein.

B. Exemplary Wedge Sled with Fixed Blade

FIG. 18 shows a perspective cutaway view of another exemplaryalternative staple cartridge (470) that is equipped with an exemplaryalternative wedge sled (478). In the present example, cartridge (470) issubstantially the same as cartridge (70, 270) described above, exceptcartridge (470) includes an upwardly projecting guard (469) that isunitarily coupled to a deck (473) of cartridge (470). Like cartridge(70, 270), cartridge (470) includes a longitudinally extending channel(472) in deck (473), which also extends through guard (469). As will bediscussed in greater detail below, guard (469) is configured to cover ablade (480), which is fixedly attached to wedge sled (478).

Wedge sled (478) is similar to wedge sled (78, 378) described above. Inthe present example, like wedge sled (378), wedge sled (478) has beenmodified relative to wedge sled (78) to accommodate a secondary cuttingblade (480) that is fixedly secured to wedge sled (478). In particular,as can best be seen in FIG. 19, wedge sled (478) includes a body (477)that defines a blade slot (482). Body (477) may also include a pluralityof cam surfaces (not shown) suitable to drive staples (77), via stapledrivers, into tissue. Body (477) is shorter relative to cam surface (79)of wedge sled (78), yet body (477) and cam surfaces are oriented at anangle that is steeper than the angle of cam surface (79) of wedge sled(78). Accordingly, wedge sled (478) occupies the same amount of spacelongitudinally within cartridge (470) as wedge sled (78), making wedgesled (478) substantially interchangeable with wedge sled (78). The angleof wedge sled (478) permit wedge sled (478) to drive multiple stapledrivers (not shown) upwardly simultaneously and/or in a certainpredetermined sequence.

Blade slot (482) is configured to accommodate the blade (480) withinwedge sled (478). As can best be seen in FIG. 19, blade slot (482) has ashape approximately corresponding to a shape defined by a lower regionof blade (480). Unlike blade (380) of wedge sled (378), blade (480) ofwedge sled (478) is fixed relative to wedge sled (478). Thus, blade slot(482) does not need to be configured to accommodate rotation or pivotingof blade (480). In other examples, blade slot (482) may have any othersuitable shape as will be apparent to those of ordinary skill in the artin view of the teachings herein.

As can be seen in FIG. 19, wedge sled (478) further comprises a pin orshaft (485), which extends through blade slot (482). A through hole(486) in blade (480) permits blade (480) to be fixedly secured to wedgesled (478) such that blade (480) is substantially fixed relative towedge sled (478).

Blade (480) has a cross-sectional shape similar to blade (380). Inparticular, blade (480) has an upper cutting portion (488) and a lowerattachment portion (494). Upper cutting portion (488) comprises adistally facing angular cutting edge (490) and a proximally facing flatportion (492). Cutting edge (490) extends at an angle upwardly fromattachment portion (494). Like with cutting edge (390) and flat portion(394) described above, cutting edge (490) and flat portion (494) maycomprise any suitable alternative configuration as will be apparent tothose of ordinary skill in the art in view of the teachings herein.

Upper cutting portion (488) of blade (480) extends upwardly to a certainheight above wedge sled (478). In the present example, the height ofupper cutting portion (488) is configured to cut through both a buttress(280) and tissue (90). Although, like with upper cutting portion (388)described above, the height of upper cutting portion (488) may be variedto cut through any desired combination of buttress (280) and/or tissue(90) as will be apparent to those of ordinary skill in the art in viewof the teachings herein.

In an exemplary mode of operation, and as shown in FIG. 19, blade (480)is retracted into guard (469) prior to insertion of cartridge (470) intolower jaw (50). When blade (480) is retracted into guard (469), blade(480) is entirely inside cartridge (470). Accordingly, an operator isprotected from inadvertent contact with blade (480) while the operatorhandles cartridge (470) and inserts cartridge (470) into lower jaw (50).Additionally, guard (469) may prevent premature contact between tissueand blade (480) during closure of anvil (60) toward deck (473), until afiring sequence is initiated (e.g., until knife member (80) is advanceddistally). For instance, in absence of guard (469), the closing actionof anvil (60) may tend to drive tissue proximally toward blade (480)when anvil (60) compresses tissue against deck (473). If such a proximal“milking” action of tissue occurs, guard (469) blocks the proximallydriven tissue from engaging blade (480).

Once an operator has inserted cartridge (470) into lower jaw (50), blade(480) remains retracted until an operator initiates the firing sequence.Once the firing sequence is initiated, firing beam (82) is drivendistally to contact wedge sled (478). As shown in FIG. 20, firing beam(82) continues to advance distally, driving wedge sled (478) distallyand thereby driving blade (480) out of guard (469), such that cuttingedge (490) of blade (480) may cut through a buttress (280) (if equipped)and tissue (90). Cutting edge (84) of knife member (80) may trailshortly behind blade (480), such that cutting edge (84) cuts any tissue(90) or buttress (280) material left uncut by blade (480). It should beunderstood that cutting edge (84) of knife member (80) and cutting edge(490) of blade (480) follow a path that is substantially identical. Sucha path may generally be defined by longitudinally extending channel(470) of cartridge (770). By making the first cutting pass throughbuttress (280) (and in some versions, tissue (90) as well), blade (480)may reduce wear and/or buildup on knife member (80), thereby prolongingthe useful life of knife member (80). Additionally, it should beunderstood that both blade (480) and knife member (80) trail camsurfaces (479) such that wedge sled (478) will drive staples (77)through a given region of tissue before that particular region of tissueis cut by blade (480) or knife member (80). The stapling and cuttingaction may still be considered substantially simultaneous at that regionof tissue because wedge sled (478) is configured such that thedifference in timing between stapling and cutting is substantiallyshort.

Once instrument (10) has been fired, cartridge (470) may be removedalong with blade (480) such that a new cartridge (70, 370, 470) and/orblade (480) may be inserted into lower jaw (50). It should be understoodthat cartridge (470) may be replaced with an identical cartridge (470)or a different cartridge (70, 270, 370). For instance, like withcartridge (370) discussed above, some cartridges (470) may be equippedwith blades (480) configured for different procedures such as thosedescribed above.

FIG. 21, shows an alternative wedge sled (578) that may be used withcartridge (70, 270, 470). Wedge sled (578) is functionally andstructurally the same as wedge sled (478) discussed above, unlessotherwise noted below. Unlike wedge sled (478), wedge sled (578)comprises a different secondary cutting blade (580). In particular,blade (580) is shorter relative to blade (480) such that blade (580) isconfigured to cut through only buttress (280) material, without alsoreaching tissue (90) positioned above buttress (280).

In some circumstances, buttress (280) material may be of a differentthickness than the particular thickness depicted. Accordingly, it shouldbe understood that cutting blade (580) is not limited to only cuttingbuttress (280) or cutting through all of buttress (280). Indeed, in somecircumstances blade (580) may incidentally cut a portion of tissue (90).Yet in other circumstances, blade (580) may cut through only a portionof buttress (280), leaving the remaining buttress (280) material forcutting by cutting edge (84) of knife member (80).

C. Exemplary Wedge Sled with Biased Secondary Blade

FIG. 22 shows a perspective view of another exemplary alternative wedgesled (678) that may be used with cartridge (670), which is a modifiedversion of cartridge (70, 270). In many respects, wedge sled (678) ofthis example is similar to wedge sled (78, 378, 478, 578) describedabove. In the present example, like wedge sled (378, 478, 578), wedgesled (678) has been modified relative to wedge sled (78) to accommodatea secondary cutting blade (680). In particular, as can best be seen inFIG. 23, wedge sled (678) includes a body (677) and a plurality of camsurfaces (679). Body (677) defines a blade slot (682), which isconfigured to accommodate a blade (680), as will be described in greaterdetail below. Body (677) and cam surfaces (679) are shorter relative tocam surface (79) of wedge sled (78), yet cam surfaces (679) are orientedat an angle that is steeper than the angle of cam surface (79) of wedgesled (78). Accordingly, wedge sled (678) occupies the same amount ofspace longitudinally within cartridge (70, 270) as wedge sled (78),making wedge sled (678) substantially interchangeable with wedge sled(78). The angle of cam surfaces (679) permit wedge sled (678) to drivemultiple staple drivers (not shown) upwardly simultaneously and/or in acertain predetermined sequence.

Blade slot (682) is configured to accommodate blade (680) within wedgesled (678). As can best be seen in FIG. 23, blade slot (682) comprises atranslation slot (683) and an actuation cavity (684). Translation slot(683) corresponds to a translation sled (692) of blade (680). As will bedescribed in greater detail below, translation sled (692) is configuredto cooperate with knife member (80) to translate blade (680) from aretracted position to an extended position via translation slot (683).

Actuation cavity (684) defines a space for certain components of blade(680) (described below) and a resilient member (686) of wedge sled(678). Resilient member (686) comprises a leaf spring that extendsproximally from a distal fixation feature (688) that is of unitaryconstruction with wedge sled (678). As will be described in greaterdetail below, resilient member (686) is operable to flex up and downwithin actuation cavity (684) to resiliently bias blade (680) toward theretracted position. Accordingly, actuation cavity (684) is at leastpartially defined by the range of flexing motion of resilient member(686). Although actuation cavity (684) is shown as having a specificshape, it should be understood that the shape of actuation cavity (684)may be varied according to the shape and range of motion of resilientmember (686). Additionally or in the alternative, as will be understoodfrom the description below, the shape of actuation cavity (684) may alsobe varied according to the shape or translation path of blade (680).

Blade (680) comprises an upper cutting portion (690), translation sled(692), and a retaining feature (694). Cutting portion (690) comprises asharp distally oriented cutting edge (691), which is configured to cutthrough buttress (280) and/or tissue (90). Like with cutting edge (390,490) described above, cutting edge (691) may have a variety ofalternative configurations that may be configured to cut through avariety of materials.

Translation sled (692) is of unitary construction with blade (680) andextends outwardly from blade (680). In other examples, translation sled(692) may be a separate from, and fixedly secured to blade (680).Translation sled (692) is generally integral with blade (680) andextends distally and outwardly from the front, right and left sides ofblade (680). As can best be seen in FIG. 22, translation sled (692) isgenerally rectangular in shape with rounded distal and proximal ends.The longitudinal portion of the rectangular shape of translation sled(692) generally defines a plane which is oriented at an oblique anglerelative to the longitudinal axis of cartridge (670). As will bedescribed in greater detail below, translation sled (692) is slidablydisposed in translation slot (683) that is formed in the body of wedgesled (680). Translation slot (683) provides a cam surface fortranslation sled (692), such that translation slot (693) and translationsled (692) provide upward movement of blade (680) relative to wedge sled(678) when blade (680) is driven distally relative to wedge sled (678).Although translation sled (692) is shown as being oriented at a specificangle relative to blade (680), it should be understood that translationsled (692) may be oriented at any suitable angle as will be apparent tothose of ordinary skill in the art in view of the teachings herein.

Retaining feature (694) extends distally from blade (680). Inparticular, retaining feature (694) initially extends substantiallyperpendicular to a longitudinal axis of blade (680). As retainingfeature (694) extends distally, retaining feature (694) curvesdownwardly at an angle. As will be understood, the shape of retainingfeature (694) is configured to engage resilient member (686) toresiliently bias blade (680) toward the retracted position. Thus,retaining feature (694) may take on a variety of alternative shapesdepending on the particular relationship between wedge sled (678) andblade (680) and other sub components thereof.

Unlike blade (380, 480, 580) of wedge sled (378, 478, 578), blade (680)of wedge sled (678) is configured to translate obliquely relative towedge sled (478). In particular, translation slot (683) of wedge sled(678) is configured to mate with translation sled (692) of blade (680).Translation slot (683) and translation sled (692) are both oriented atan angle such that translation slot (683) and translation sled (692) areoperable to cooperatively translate blade (680) upwardly as blade (680)is advanced distally. Thus, translation slot (683) and translation sled(692) are operable to transition blade (680) from the retracted positionto the extended position when blade (680) is advanced distally.

As can best be seen in FIG. 23, resilient member (686) of wedge sled(678) and retaining feature (694) of blade (680) are configured toengage each other such that resilient member (686) exerts a force havinga downward component and a proximal component on retaining feature(694). This force causes translation sled (692) of blade (680) to bebiased toward the proximal end of translation slot (683) of wedge sled(678), thus resiliently biasing blade (680) toward the retractedposition. In some versions, the distal edge of distal projection (83) isoriented at an angle between 75 degrees and 90 degrees relative to ahorizontal plane. Such an angle may provide a camming action thatassists in overcoming the bias of resilient member (686) to retractblade (680) proximally.

In an exemplary mode of operation, blade (680) is retracted initially inthe retracted position for insertion of cartridge (670) into lower jaw(50). When blade (680) is in the retracted position, blade (680) isentirely inside cartridge (670). Accordingly, an operator is protectedfrom inadvertent contact with blade (680) while inserting cartridge(670) into lower jaw (50).

Once an operator has inserted cartridge (670) into lower jaw (50), blade(680) remains retracted until an operator initiates the firing sequence.Once the firing sequence is initiated, firing beam (82) is drivendistally such that knife member (80) contacts blade (680) to firstactuate blade (680) into the extended position and then to drive blade(680) and wedge sled (678) proximally. As shown in FIGS. 23-24, knifemember (80) comprises a distal projection (83) which is configured tocontact blade (680). Thus, as firing beam (82) is driven distally, blade(680) is correspondingly driven distally relative to wedge sled (678) bydistal projection (83) of knife member (80). As blade (680) is drivendistally, translation slot (683) of wedge sled (678) and translationsled (692) of blade (680) simultaneously and cooperatively drive blade(680) upwardly into the extended position, as can be seen in thetransition from the state shown in FIG. 23 to the state shown in FIG.24. It should be understood that, because blade (680) is resilientlybiased toward the retracted position, blade (680) is only extended whenacted upon by knife member (80). Continued advancement of firing beam(82) advances wedge sled (678) distally and drives cutting edge (691) ofblade (680) through buttress (280) and/or tissue (90). Cutting edge (84)of knife member (80) may trail shortly behind blade (680), such thatcutting edge (84) cuts any tissue (90) or buttress (280) material leftuncut by blade (680).

It should be understood that cutting edge (84) of knife member (80) andcutting edge (690) of blade (680) follow a path that is substantiallyidentical. Such a path may generally be defined by longitudinallyextending channel (not shown) of cartridge (670). By making the firstcutting pass through buttress (280) (and in some versions, tissue (90)as well), blade (680) may reduce wear and/or buildup on knife member(80), thereby prolonging the useful life of knife member (80).Additionally, it should be understood that both blade (680) and knifemember (80) trail cam surfaces (379) such that wedge sled (678) willdrive staples (77) through a given region of tissue before thatparticular region of tissue is cut by blade (680) or knife member (80).The stapling and cutting action may still be considered substantiallysimultaneous at that region of tissue because wedge sled (678) isconfigured such that the difference in timing between stapling andcutting is substantially short.

Once instrument (10) has been fired, knife member (80) may be retractedproximally. Proximal retraction of knife member (80) permits resilientmember (686) to drive blade (680) back to the retracted position. Blade(680) is thus retracted in a spent cartridge (670), protecting theoperator from inadvertent contact with cutting edge (691) when operatorremoves the spent cartridge (670) to replace spent cartridge (670) or tootherwise dispose of the spent cartridge (670). Cartridge (670) may beremoved along with blade (680) such that a new cartridge (70, 270, 370,470, 570), equipped with blade (380, 480, 580, 680), may be insertedinto lower jaw (50). It should be understood that cartridge (670) may bereplaced with an identical cartridge (670) or a different cartridge (70,270, 370, 470, 570). For instance, like with wedge sled (378, 478, 578)discussed above, some cartridges (70, 270, 370, 470, 570) may beequipped with blades (680) configured for different procedures such asthose described above.

D. Exemplary Wedge Sled with Translatable Blade

FIGS. 25-26 show another exemplary alternative wedge sled (778) for usewith cartridge (770), which is a modified version of cartridge (70,270). In many respects, wedge sled (778) of this example is similar towedge sled (78, 378, 478, 578, 678) described above. Like wedge sled(378, 478, 578, 678), wedge sled (778) has been modified relative towedge sled (78) to include an integral secondary cutting blade (780). Inparticular, as can best be seen in FIG. 25, wedge sled (778) includes abody (777) and a cam surface (779). Body (777) and cam surface (779) areshorter relative to cam surface (79) of wedge sled (78), yet cam surface(779) is oriented at an angle that is steeper than the angle of camsurface (79) of wedge sled (78). Accordingly, wedge sled (778) occupiesthe same amount of space longitudinally within cartridge (70, 270) aswedge sled (78), making wedge sled (778) substantially interchangeablewith wedge sled (78). The angle of cam surfaces (779) permit wedge sled(778) to drive multiple staple drivers (75) upwardly simultaneouslyand/or in a certain predetermined sequence.

Blade (780) comprises an upper cutting portion (790), a body portion(792), and a stabilizing member (794). Cutting portion (790) comprises asharp, distally oriented cutting edge (791), which is configured to cutthrough buttress (280) and/or tissue (90). Like with cutting edge (390,490, 590, 691) described above, cutting edge (791) may have a variety ofalternative configurations that may be configured to cut through avariety of materials.

Body portion (792) unitary couples blade (780) with wedge sled (778). Inother words, wedge sled (778) and blade (780) comprise a single unitarycomponent in this example. In other examples, blade (780) may beseparate from, and fixedly secured to, wedge sled (778). Body portion(792) is sized to raise cutting portion (790) to height suitable forcutting buttress (280). While body portion (792) is shown as having aparticular height, it should be understood that the height of bodyportion (792) may be varied according to a number of factors such as theheight of deck (773), buttress (280) thickness, etc.

Stabilizing member (794) is positioned above cutting edge (791) andextends distally from blade (780). As can best be seen in FIG. 26,stabilizing member (794) is positioned to align with a top surface ofbuttress (280). Accordingly, stabilizing member (794) is operable todirect buttress (280) toward cutting edge (791), and may further assistin preventing buttress (280) from separating from deck (773) in theregion adjacent to blade (780), as will be described in greater detailbelow. Additionally, stabilizing member (794) acts as a guard to preventinadvertent operator contact with cutting edge (791). Althoughstabilizing member (794) is shown as having a generally rectangularshape extending a particular distance, it should be understood thatstabilizing member (794) may have any suitable size or shape. Forinstance, in other examples stabilizing member (794) may extend distallyfurther than depicted. Yet in other examples, stabilizing member (794)may taper outwardly or inwardly to a width that is wider or narrowerthan blade (780), respectively. Of course, stabilizing member (794) maycomprise any other suitable configuration, size, and/or shape as will beapparent to those of ordinary skill in the art in view of the teachingsherein.

In an exemplary mode of operation, blade (780) initially protrudes outof cartridge (70, 270) at the proximal end of cartridge (70, 270).Stabilizing member (794) is configured to protect an operator frominadvertent contact with cutting edge (791) while cartridge (70, 270) isinserted into lower jaw (50). Accordingly, an operator is protected frominadvertent contact with blade (780) even though blade (780) projectsoutwardly from cartridge (70, 270).

Once a user has inserted cartridge (70, 270) into lower jaw (50), thefiring sequence may be initiated. Once the firing sequence is initiated,firing beam (82) is driven distally such that knife member (80) contactswedge sled (778). As shown in FIG. 26, knife member (80) contacts wedgesled (778) and begins to drive wedge sled (778) and blade (780)distally. As blade (780) is driven distally, stabilizing member (794) ofwedge sled (778) rides on the upper surface of buttress (280) tostabilize the cutting process. It should be understood that, sincestabilizing member (794) rides on top of buttress (280), blade (780)only cuts buttress (280). In other examples, cutting edge (791) of blade(780) may be configured to be vertically higher. In some such examples,stabilizing member (794) may ride on tissue (90) or a buttress (280)that is adjacent to anvil (60). Thus, in other examples, blade (780) maybe configured to cut other materials besides buttress (280) such astissue (90) or other additional buttresses (280). Cutting edge (84) ofknife member (80) may trail shortly behind blade (780), such thatcutting edge (84) cuts any tissue (90) or buttress (280) material leftuncut by blade (780).

It should be understood that cutting edge (84) of knife member (80) andcutting edge (790) of blade (780) follow a path that is substantiallyidentical. Such a path may generally be defined by longitudinallyextending channel (not shown) of cartridge (770). By making the firstcutting pass through buttress (280) (and in some versions, tissue (90)as well), blade (780) may reduce wear and/or buildup on knife member(80) thereby prolonging the useful life of knife member (80).Additionally, it should be understood that both blade (780) and knifemember (80) trail cam surfaces (779) such that wedge sled (778) willdrive staples (77) through a given region of tissue before thatparticular region of tissue is cut by blade (480) or knife member (80).The stapling and cutting action may still be substantially simultaneousat that region of tissue because wedge sled (778) is configured suchthat the difference in timing between stapling and cutting issubstantially short.

Once instrument (10) has been fired, cartridge (70, 270) may be removedalong with blade (780) such that a new cartridge (70, 270, 470, 570) maybe inserted into lower jaw (50). It should be understood that cartridge(70, 270) may be replaced with an identical cartridge (70, 270) or adifferent cartridge (70, 270, 470, 570). For instance, like with wedgesled (378, 478, 578, 678) discussed above, some cartridges (570) may beequipped with blades (780) configured for different procedures such asthose described above.

IV. Miscellaneous

It should be understood that in the various examples described above, anarticulation joint is configured to permit an end effector to articulatealong a first plane and thereby deflect away from the longitudinal axisof a shaft assembly. A locking assembly is operable to selectively lockthe articulation joint. The locking assembly includes a locking memberthat is movable along a second plane to selectively engage the firstlocking member and thereby lock the articulation joint. The second planeis offset from the first plane. The second plane is also non-parallelwith the first plane. In some instances, the second locking member ismovable along a second axis that is perpendicular to the longitudinalaxis of the shaft assembly. An unlocking member may selectively drivethe locking member. The unlocking member may move along a third plane,which may be offset from and/or in a non-parallel relationship with thefirst and/or second plane(s). The unlocking member may move along athird axis, which may be perpendicular to the longitudinal axis of theshaft assembly and/or the second axis.

It should be understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Theabove-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims. It should also be understoodthat the various teachings herein may be readily combined with theteachings of the various references that are cited herein.

It should be appreciated that any patent, publication, or otherdisclosure material, in whole or in part, that is said to beincorporated by reference herein is incorporated herein only to theextent that the incorporated material does not conflict with existingdefinitions, statements, or other disclosure material set forth in thisdisclosure. As such, and to the extent necessary, the disclosure asexplicitly set forth herein supersedes any conflicting materialincorporated herein by reference. Any material, or portion thereof, thatis said to be incorporated by reference herein, but which conflicts withexisting definitions, statements, or other disclosure material set forthherein will only be incorporated to the extent that no conflict arisesbetween that incorporated material and the existing disclosure material.

Versions of the devices described above may have application inconventional medical treatments and procedures conducted by a medicalprofessional, as well as application in robotic-assisted medicaltreatments and procedures. By way of example only, various teachingsherein may be readily incorporated into a robotic surgical system suchas the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, Calif.Similarly, those of ordinary skill in the art will recognize thatvarious teachings herein may be readily combined with various teachingsof any of the following: U.S. Pat. No. 5,792,135, entitled ARTICULATEDSURGICAL INSTRUMENT FOR PERFORMING MINIMALLY INVASIVE SURGERY WITHENHANCED DEXTERITY AND SENSITIVITY, issued Aug. 11, 1998, the disclosureof which is incorporated by reference herein; U.S. Pat. No. 5,817,084,entitled REMOTE CENTER POSITIONING DEVICE WITH FLEXIBLE DRIVE, issuedOct. 6, 1998, the disclosure of which is incorporated by referenceherein; U.S. Pat. No. 5,878,193, entitled AUTOMATED ENDOSCOPE SYSTEM FOROPTIMAL POSITIONING, issued Mar. 2, 1999, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 6,231,565, entitledROBOTIC ARM DLUS FOR PERFORMING SURGICAL TASKS, issued May 15, 2001, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.6,783,524, entitled ROBOTIC SURGICAL TOOL WITH ULTRASOUND CAUTERIZINGAND CUTTING INSTRUMENT, issued Aug. 31, 2004, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 6,364,888, entitledALIGNMENT OF MASTER AND SLAVE IN A MINIMALLY INVASIVE SURGICALAPPARATUS, issued Apr. 2, 2002, the disclosure of which is incorporatedby reference herein; U.S. Pat. No. 7,524,320, entitled MECHANICALACTUATOR INTERFACE SYSTEM FOR ROBOTIC SURGICAL TOOLS, issued Apr. 28,2009, the disclosure of which is incorporated by reference herein; U.S.Pat. No. 7,691,098, entitled PLATFORM LINK WRIST MECHANISM, issued Apr.6, 2010, the disclosure of which is incorporated by reference herein;U.S. Pat. No. 7,806,891, entitled REPOSITIONING AND REORIENTATION OFMASTER/SLAVE RELATIONSHIP IN MINIMALLY INVASIVE TELESURGERY, issued Oct.5, 2010, the disclosure of which is incorporated by reference herein;U.S. Patent Application Publication No. 2013/0012957, entitled AUTOMATEDEND EFFECTOR COMPONENT RELOADING SYSTEM FOR USE WITH A ROBOTIC SYSTEM,published Jan. 10, 2013, now U.S. Pat. No. 8,844,789, the disclosure ofwhich is incorporated by reference herein; U.S. Patent ApplicationPublication No. 2012/0199630, entitled ROBOTICALLY-CONTROLLED SURGICALINSTRUMENT WITH FORCE-FEEDBACK CAPABILITIES, published Aug. 9, 2012, nowU.S. Pat. No. 8,820,605, the disclosure of which is incorporated byreference herein; U.S. Patent Application Publication No. 2012/0132450,entitled SHIFTABLE DRIVE INTERFACE FOR ROBOTICALLY-CONTROLLED SURGICALTOOL, published May 31, 2012, now U.S. Pat. No. 8,616,431, thedisclosure of which is incorporated by reference herein; U.S. PatentApplication Publication No. 2012/0199633, entitled SURGICAL STAPLINGINSTRUMENTS WITH CAM-DRIVEN STAPLE DEPLOYMENT ARRANGEMENTS, publishedAug. 9, 2012, now U.S. Pat. No. 8,573,461, the disclosure of which isincorporated by reference herein; U.S. Patent Application PublicationNo. 2012/0199631, entitled ROBOTICALLY-CONTROLLED MOTORIZED SURGICAL ENDEFFECTOR SYSTEM WITH ROTARY ACTUATED CLOSURE SYSTEMS HAVING VARIABLEACTUATION SPEEDS, published Aug. 9, 2012, now U.S. Pat. No. 8,602,288,the disclosure of which is incorporated by reference herein; U.S. PatentApplication Publication No. 2012/0199632, entitledROBOTICALLY-CONTROLLED SURGICAL INSTRUMENT WITH SELECTIVELYARTICULATABLE END EFFECTOR, published Aug. 9, 2012, now U.S. Pat. No.9,301,759, the disclosure of which is incorporated by reference herein;U.S. Patent Application Publication No. 2012/0203247, entitledROBOTICALLY-CONTROLLED SURGICAL END EFFECTOR SYSTEM, published Aug. 9,2012, now U.S. Pat. No. 8,783,541, the disclosure of which isincorporated by reference herein; U.S. Patent Application PublicationNo. 2012/0211546, entitled DRIVE INTERFACE FOR OPERABLY COUPLING AMANIPULATABLE SURGICAL TOOL TO A ROBOT, published Aug. 23, 2012, nowU.S. Pat. No. 8,479,969; U.S. Patent Application Publication No.2012/0138660, entitled ROBOTICALLY-CONTROLLED CABLE-BASED SURGICAL ENDEFFECTORS, published Jun. 7, 2012, now U.S. Pat. No. 8,800,838, thedisclosure of which is incorporated by reference herein; and/or U.S.Patent Application Publication No. 2012/0205421, entitledROBOTICALLY-CONTROLLED SURGICAL END EFFECTOR SYSTEM WITH ROTARY ACTUATEDCLOSURE SYSTEMS, published Aug. 16, 2012, now U.S. Pat. No. 8,573,465,the disclosure of which is incorporated by reference herein.

Versions of the devices described above may be designed to be disposedof after a single use, or they can be designed to be used multipletimes. Versions may, in either or both cases, be reconditioned for reuseafter at least one use. Reconditioning may include any combination ofthe steps of disassembly of the device, followed by cleaning orreplacement of particular pieces, and subsequent reassembly. Inparticular, some versions of the device may be disassembled, and anynumber of the particular pieces or parts of the device may beselectively replaced or removed in any combination. Upon cleaning and/orreplacement of particular parts, some versions of the device may bereassembled for subsequent use either at a reconditioning facility, orby a user immediately prior to a procedure. Those skilled in the artwill appreciate that reconditioning of a device may utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

By way of example only, versions described herein may be sterilizedbefore and/or after a procedure. In one sterilization technique, thedevice is placed in a closed and sealed container, such as a plastic orTYVEK bag. The container and device may then be placed in a field ofradiation that can penetrate the container, such as gamma radiation,x-rays, or high-energy electrons. The radiation may kill bacteria on thedevice and in the container. The sterilized device may then be stored inthe sterile container for later use. A device may also be sterilizedusing any other technique known in the art, including but not limited tobeta or gamma radiation, ethylene oxide, or steam.

Having shown and described various embodiments of the present invention,further adaptations of the methods and systems described herein may beaccomplished by appropriate modifications by one of ordinary skill inthe art without departing from the scope of the present invention.Several of such potential modifications have been mentioned, and otherswill be apparent to those skilled in the art. For instance, theexamples, embodiments, geometrics, materials, dimensions, ratios, steps,and the like discussed above are illustrative and are not required.Accordingly, the scope of the present invention should be considered interms of the following claims and is understood not to be limited to thedetails of structure and operation shown and described in thespecification and drawings.

What is claimed is:
 1. A surgical instrument, comprising: a housing; afiring drive comprising an electric motor and a firing member, whereinsaid electric motor is configured to advance said firing member througha firing stroke; a shaft extending from said housing; an end effectorcomprising a first jaw and a second jaw; and a replaceable staplecartridge removably seated in said first jaw, comprising: a cartridgebody comprising a proximal end, a distal end, and a deck; staplecavities defined in said cartridge body; staples removably positioned insaid staple cavities; staple drivers configured to push said staplestoward said second jaw during said firing stroke; and a sled movablebetween a proximal position and a distal position by said firing memberduring said firing stroke, wherein said sled comprises: a sled bodycomprising ramps configured to engage said staple drivers and move saidstaple drivers within said staple cavities during said firing stroke;and a knife deployable between an undeployed position and a deployedposition when said firing member contacts said sled, wherein said knifedoes not extend above said deck when said knife is in said undeployedposition, wherein said knife extends above said deck when said knife isin said deployed position, and wherein said knife returns from saiddeployed position to said undeployed position when said firing member isdisengaged from said sled.
 2. The surgical instrument of claim 1,wherein said sled further comprises a biasing member configured toreturn said knife from said deployed position to said undeployedposition when said firing member is disengaged from said sled.
 3. Thesurgical instrument of claim 1, wherein said firing member comprises: afirst member configured to engage said first jaw during said firingstroke; and a second member configured to engage said second jaw duringsaid firing stroke.
 4. The surgical instrument of claim 1, wherein saidhousing comprises a handle.
 5. The surgical instrument of claim 1,wherein said housing is configured to be attached to a robotic surgicalsystem.
 6. A surgical instrument, comprising: a firing drive comprisingan electric motor and a firing member, wherein said electric motor isconfigured to advance said firing member through a firing stroke; an endeffector comprising a first jaw and a second jaw; and a staple cartridgeseated in said first jaw, comprising: a cartridge body comprising aproximal end, a distal end, and a deck; staple cavities defined in saidcartridge body; staples removably positioned in said staple cavities;staple drivers configured to push said staples toward said second jawduring said firing stroke; and a sled movable from a proximal positionto a distal position by said firing member during said firing stroke,wherein said sled comprises: a sled body comprising ramps configured toengage said staple drivers and move said staple drivers within saidstaple cavities during said firing stroke; and a knife deployablebetween a recessed position and an extended position when said firingmember contacts said sled, wherein said knife extends above said deckwhen said knife is in said extended position, and wherein said knifereturns from said extended position to said recessed position when saidfiring member is retracted proximally away from said sled.
 7. Thesurgical instrument of claim 6, wherein said sled further comprises abiasing member configured to return said knife from said extendedposition to said recessed position when said firing member is disengagedfrom said sled.
 8. The surgical instrument of claim 6, wherein saidfiring member comprises: a first member configured to engage said firstjaw during said firing stroke; and a second member configured to engagesaid second jaw during said firing stroke.
 9. The surgical instrument ofclaim 6, further comprising a handle.
 10. The surgical instrument ofclaim 6, further comprising a housing configured to be attached to arobotic surgical system.
 11. A stapling assembly, comprising: a firingdrive comprising a firing member movable through a firing stroke; an endeffector comprising a first jaw and a second jaw; and a replaceablestaple cartridge, comprising: a cartridge body comprising a proximalend, a distal end, and a deck; staple cavities defined in said cartridgebody; staples removably positioned in said staple cavities; and a sledmovable from a proximal position to a distal position by said firingmember during said firing stroke to drive said staples out of saidstaple cavities, wherein said sled comprises tissue cutting meansdeployable between a lowered position and a raised position when saidfiring member engages said sled, wherein said tissue cutting meansextends above said deck when said tissue cutting means is in said raisedposition, and wherein said tissue cutting means returns from said raisedposition to said lowered position when said firing member is disengagedfrom said sled.
 12. The stapling assembly of claim 11, wherein said sledfurther comprises a biasing member configured to return said tissuecutting means from said raised position to said lowered position whensaid firing member is disengaged from said sled.
 13. The staplingassembly of claim 11, wherein said firing member comprises: a firstmember configured to engage said first jaw during said firing stroke;and a second member configured to engage said second jaw during saidfiring stroke.
 14. The stapling assembly of claim 11, further comprisinga handle.
 15. The stapling assembly of claim 11, further comprising ahousing configured to be attached to a robotic surgical system.
 16. Astaple cartridge, comprising: a cartridge body comprising a proximalend, a distal end, and a deck; staple cavities defined in said cartridgebody; staples removably positioned in said staple cavities; and a sledmovable between a proximal position and a distal position by a firingmember of a stapling instrument during a firing stroke, wherein saidsled comprises: a sled body configured to drive said staples out of saidstaple cavities during said firing stroke; and a knife deployablebetween a lowered position and a raised position when the firing memberengages said sled, wherein said knife extends above said deck when saidknife is in said raised position, and wherein said knife returns fromsaid raised position to said lowered position when the firing member isdisengaged from said sled.